Category Archives: Health Care Reform: Payment Reform

American Hospital Association: Your Hospital’s Path to the Second Curve – Integration and Transformation

This issue brief from the American Hospital Association (AHA) describes the need for hospitals to transform from volume-based payments to value-based revenue and business models. Environmental pressures are driving hospitals and care systems toward greater clinical integration, more financial risk … Continue reading

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Health Research & Education Trust: Second Curve Roadmap for Health Care

This “roadmap” from the Health Research & Education Trust of the American Hospital Association uses a futurist framework to describe the coming of the “second curve” (phase) for health care organizations, moving from a “first curve” of volume-based, largely fee-for-service … Continue reading

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Health Research & Education Trust: Metrics for the Second Curve of Health Care

This report from the American Hospital Association’s Health Research and Education Trust describes how hospitals and health systems will need to shift from a “first curve” of primarily fee-for-service, volume-based payments to a “second curve” of value-based payments based on … Continue reading

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Centers for Medicare & Medicaid Services: Additional $730 Million Available for State Innovation Models

The Center for Medicare and Medicaid Innovation at the Centers for Medicare and Medicaid Services (CMS) has announced the availability of an additional $730 million for states to design and implement State Innovation Models. These awards provide significant flexibility to … Continue reading

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Congress Outlines Bipartisan Agreement for Repeal of Medicare Sustainable Growth Rate Payment Formula

The bipartisan leadership of the House Ways and Means Committee, House Energy and Commerce Committee, and Senate Finance Committee have announced an agreement to finally repeal and replace the problematic Medicare Sustained Growth Rate (SGR) payment formula for physicians under … Continue reading

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Centers for Medicare & Medicaid Services: Request for Information on Accountable Care Organization Models

The Centers for Medicare & Medicaid Services (CMS) has issued a request for information for comments and ideas about accountable care organization (ACO) models, including whether CMS should fund another round of Pioneer ACOs, and what new or alternate ACO … Continue reading

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Commonwealth Fund: Better Care at Lower Costs

This issue brief from The Commonwealth Fund uses large fonts, simpler English, and infographics to explain issues of quality improvement and cost reductions that are essential to reforming the U.S. health care system. The issue brief explains the concepts of … Continue reading

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RWJF-Health Affairs Policy Brief: Medicare Hospital Readmissions Reduction Program

This Robert Wood Johnson Foundation-Health Affairs policy brief describes the Medicare Hospital Readmissions Reduction Program. In 2009, the Centers for Medicare & Medicaid Services (CMS) began public reporting of hospital readmissions rates. However, prior to the enactment of the Patient … Continue reading

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Centers for Medicare & Medicaid Services: Hospital Readmission Reduction Program

These are the technical specifications from the Centers for Medicare & Medicaid Services (CMS) instructing hospitals how to report readmissions and calculate avoidable readmissions. ┬áBeginning last October 2012, CMS began to impose penalties for “excess” or avoidable readmissions through the … Continue reading

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4th National ACO Congress: Health Care Transformation is Really Hard, and Takes a Long Time

The fourth annual National Accountable Care Organization (ACO) Congress was held this week in Los Angeles, California. The inaugural conference, held eight months after the enactment of Patient Protection and Affordable Care Act (ACA), but before even proposed regulations for … Continue reading

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